Interactive Case Studies - Overview

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A 66-Year-Old Woman With Liver-Limited Metastatic Colorectal Cancer

Release Date: July 31, 2008
Expiration Date: July 31, 2009

Interactive Case Study Overview

Data from recent randomized studies have indicated that upon diagnosis of metastatic colorectal cancer (mCRC), disease is limited to the liver in approximately one fourth of all cases. Multimodality treatment might be curative in those patients who have also been deemed as having surgically resectable liver lesions. In addition to improvements in surgical techniques, substantial progress has been made in increasing the rate of curative resection through the use of neoadjuvant and perioperative cytotoxic chemotherapy regimens in combination with biologic agents. Choosing the most beneficial agents and timing for chemotherapy and surgery remains challenging. Due to the known effects of cytotoxic chemotherapy on liver histology and the adverse effects on postoperative morbidity, optimizing chemotherapy and the timing of liver resection are critical. The addition of epidermal growth factor receptor (EGFR)–targeted antibodies to first-line irinotecan-containing chemotherapy has more than doubled the R0 resection rate in patients with CRC undergoing liver metastectomy. An awareness of published clinical trials addressing the impact of perioperative chemotherapy and biologic agents on the chance for curative resection will aid in improving patient outcome and safety.

The purpose of this activity is to review current clinical trial data regarding optimizing perioperative chemotherapy and surgical timing for patients with resectable mCRC within a case-based scenario.

Target Audience

This educational activity is intended for medical oncologists involved in the care of patients with CRC. No specific skills or knowledge other than a basic training in oncology is required for successful participation in this activity.

Target Audience

Upon completion of this educational activity, you should be able to:

  • Discuss the efficacy and toxicity of perioperative chemotherapy containing cytotoxic agents in patients with resectable mCRC
  • Evaluate patient characteristics that predict response to anti-EGFR monoclonal antibody therapy plus chemotherapy as first-line treatment for patients with resectable mCRC
  • Discuss current data on the pros and cons of perioperative chemotherapy in patients with resectable liver-limited mCRC

Instructions for Participation

  1. Read the following information before beginning the educational activity.
  2. Study the educational activity.
  3. Complete the CME test.
  4. Answer the evaluation questions.
  5. After successful completion of the CME test and evaluation, you will receive your certificate of credit online.

Successful completion is determined by a score of 67% or greater.

Read all of the conditions in the Activity Terms box below. You must accept the Activity Terms in order to continue:

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Alan Venook, MD
Research Funding – Amgen; Genentech, Inc.; Novartis Pharmaceuticals Corporation; Pfizer Inc.

PER Editorial Staff
No relevant relationships to disclose

This CME activity might include discussion of investigational and/or unlabeled uses of drugs. If the activity includes discussion of investigational and/or unlabeled uses of a drug, specific information is located on the title page. Please refer to the full prescribing information for each drug discussed in this newsletter for FDA-approved dosing, indications, and warnings.

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Banner Illustration

Illustrator: Pam Curry

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All correspondence should be directed to:
Editor, Interactive Case Study: A 66-Year-Old Woman With Liver-Limited Metastatic Colorectal Cancer
Physicians’ Education Resource
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Suite 700
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Phone: (214) 367-3456
Fax: (214) 367-3304
E-mail: editor@pergrouplp.com

Educational Grants

An educational grant for this activity was provided by:


  1. Bristol-Myers Squibb/
    ImClone Systems

Alan P. Venook, MD
Professor of Clinical Medicine
Division of Medical Oncology
UCSF Helen Diller Family Comprehensive Cancer Center
University of California, San Francisco
San Francisco, CA